If you don't have insurance you can negotiate your bill. The problem is that people don't understand that, that Americans hate negotiating, and that negotiating the price of something after you bought it (or even after you need it) stinks.
So it was kind of negotiated, but through insurance and their negotiated rates not an individual's out of pocket negotiated rates.
This was also a service where I wasn't informed that a second doctor was out of network, which also screwed me me (and there's literally nothing I can do about this after the fact).
Of course, that stance is in their best interest and not mine... so maybe I wasn't being forward enough?
This all feels quite ridiculous.
It honestly depends on the individual hospital. They almost always have a contract with insurance that they can't accept less, but nobody's checking and it's common for them to do so. Some hospitals are reasonable and especially if they see if you have low income/assets, will settle with you. Others don't care at all and will not accept any less and just send you to collections or sue.
Clearly, that is not the case.
And in regards to your last point, what has made the system so perverse is the insurance companies in the first place. If most people were actually responsible for paying all of their healthcare costs themselves, the prices would be pretty cheap.
For example, I live in Tanzania, and I can get medication that is over $500/month without insurance in the US, or like $75 with insurance, for around $1-$2. Also, I can get a tooth pulled for under $5.
No one has health insurance here, I don't think it even exists, and therefore, hospitals are forced to charge an amount that the people can pay for. The system actually works, and if for some reason you can't pay, you can volunteer at the hospital until your bill is paid off.
Consequentially, even though there aren't laws about accepting all patients (hospitals are allowed to turn away whoever they like), they don't, because they know they will be paid at the very least in labor.
Though, honestly, at this point in the US the system is so fucked up that I'm not sure it's even possible to create a free-market system anymore. It pains me to say this (as a staunch libertarian), but I think maybe it would be better at this point for the government to just foot the bill for everyone.
I have been close to ruin and you can reach a point where things are so overwhelming that you basically just give up. I am sure some people are natural fighters but a lot of people aren’t. In addition when you run out of money you can’t afford lawyers and other advice which makes things even worse. It’s a really bad negative spiral.
No. Such panic-inducing tactics are not likely to make someone a better negotiator.
Learned helplessness is a real problem.
> Clearly, that is not the case.
when it "clearly" is the case.
However, starting about 5 years ago some hospital got the idea they could refuse to negotiate with everyone and it seems to have spread. Now there are a bunch of these unreasonable hospitals. You can open up all your finances and show that you have no money and that their bill is 100x medicare rate and they would rather get $0 and you declare bankruptcy. I guess they end up getting more revenue overall this way?
gowld, I'm looking at you.
We have too much third-party payer, especially mandated third-party payer, that distorts the face value of these services.
Sectors of health care that are largely cash-based, such as corrective eye surgery, many orthodontic treatments, most plastic surgery, are all quite cheap and have up front pricing that is easy to follow. Actual healthcare reform needs to rip out the old, broken systems and replace them with a simple plan for chronic healthcare needs, insist on transparency in pricing, and let the market take care of the rest.
We manage to solve all kinds of other problems with these same structures despite the fact that the people working in them have not achieved your level of sainthood.
With medical care, I would guess the court would side with the medical care provider, and negotiating beforehand would help you, whereas not negotiating beforehand would give a blank check to the seller (as the system is now).
Yes, it works if they have actually stuck you with a bill that exceeds your net worth and expected income, but in that case you can't afford and/or don't need a negotiator -- you just default. It also works if you've stirred up a media frenzy, but you can't turn that into a business model for obvious reasons. The only place it does reliably work is in the imagination of those looking to downplay the severity of the current state of affairs.